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Little is known about the incidence and impact of infective complication on clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. The present study was aimed to demonstrate the association between infective complication and in hospital mortality or major adverse cardiovascular events (MACEs) in STEMI patients.
We prospectively enrolled 2284 STEMI patients undergoing primary percutaneous coronary intervention between January 2010 and June 2016. Detailed information on infection was collected for all patients. Multivariate analysis was performed to assess the clinical outcomes among patients with and without infections after adjusting for associated clinical variables. MACEs included the incidence of in hospital mortality, or target vessel revascularization, or re-myocardial infraction, or cerebrovascular events.
Overall, 459 patients developed an infection (20.1%), most of whom presented with a single-site infection. The most commonly identified organism was pneumonia infection. Patients complicated infections had more comorbidities than those without infections (hypertension: 60.1% vs. 50.1%; diabetes mellitus: 36.6% vs. 24.3%; chronic lung disease: 1.6% vs. 0.6%; p＜0.05, respectively). Furthermore, patients complicated with infection were related to significantly higher incidences of in hospital mortality (adjusted odds ratio: 6.2; 95% confidence interval: 3.9 to 9.7) and MACEs (adjusted odds ratio: 6.9; 95% confidence interval: 4.6 to 10.2).
Patients with STEMI complicated with infections were common and related to markedly worse in hospital clinical outcomes. Strategies for early identifying these high-risk patients and reducing their risk of infection are warranted.